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An area-level analysis of community pharmacies has revealed that the most deprived areas in England have the highest number of pharmacies per head of population, but ongoing pharmacy closures are putting this at risk.
The study, published in BMJ Open on 11 May 2025, revealed that there were an average of 2.01 pharmacies per 10,000 people in the 20% most deprived areas in England in 2023, compared with 1.33 pharmacies per 10,000 people in the 20% least deprived areas, using index of multiple deprivation data.
However, while pharmacy closures have affected all regions of England, the most deprived areas have been hit hardest — with these areas experiencing a decline in pharmacy access around four times greater than the least deprived areas, the study results show.
The analysis revealed that the most deprived areas had an average of 2.28 (2.12, 2.39) pharmacies per 10,000 people in 2014, compared with 1.37 pharmacies per 10,000 people in the least deprived areas.
From 2014 to 2023, there was a 11.8% reduction in pharmacies in the most deprived areas compared with a 3.0% reduction in the least deprived areas.
In 2023, across all areas in England, the median number of community pharmacies per 10,000 people was 1.51 — a decrease from 1.60 pharmacies per 10,000 people in 2014, according to the study results.
The authors expressed that while the study highlights the ‘positive pharmacy care law’, the fact that people in more deprived areas have the greatest access to pharmacies means that it is being “eroded”, owing to pharmacy closures.
“There is now a greater reliance on community pharmacies per 10,000 population, and this is greatest in deprived areas — this puts pressure on services and staff,” they said.
“There is potential that there will be less capacity to provide the additional enhanced clinical services for community pharmacies located in the most deprived areas.”
Eman Zied Abozied, research associate at Newcastle University’s Population Health Sciences Institute and lead author of the study, commented: “Funding cuts across the sector have seen many community pharmacies close, which could fuel inequalities in healthcare access.
“While it is encouraging that our analysis shows that most people still live close to a pharmacy, the reduction in the number of community pharmacies is a cause for concern. Pharmacies are serving a higher number of people, with the biggest decline in availability in communities that have the greatest health needs, leading to immense pressure on services and staff.
“If community pharmacies are required to deliver more clinical services to support other primary care organisations, it is important that they have the appropriate funding to be able to achieve this,” Zied Abozied added.
Commenting on the study, Malcolm Harrison, chief executive of the Company Chemists’ Association, said: “While it is positive to hear that community pharmacy continues to offer increased access to healthcare in areas of the highest deprivation, the positive pharmacy law is under threat due to the financial strain of ten years of cuts to funding. Those cuts have resulted in both permanent closures and pharmacies having to reduce their opening hours.
“This government’s recent commitment to increasing the funding for community pharmacy is a good first step to righting this. However, there remains a considerable gap between what pharmacies are paid and what it costs to deliver NHS pharmaceutical services.
“Investment in community pharmacy is necessary for building capacity and resilience in primary care. The pharmacy network is ideally placed to realise the government’s vision of preventative healthcare, delivering greater care closer to the community.”
In January 2023, The Pharmaceutical Journal revealed that pharmacies in England’s most health-deprived areas — calculated based on the population’s risk of premature death and quality of life through poor physical or mental health — provided, on average, more services to their local communities compared with less health-deprived areas.
However, it also found that health-deprived regions were experiencing a greater proportion of pharmacy closures compared with the least deprived.
